Acute promyelocytic leukemia (APL) is treated differently than other forms of acute myeloid leukemia.
Many people with APL are first treated with a drug called all-trans-retinoic acid (ATRA), also called tretinoin (Vesanoid®). ATRA is given in combination with another drug called arsenic trioxide (Trisenox®). Both of these drugs were pioneered at Memorial Sloan Kettering.
Most people have a complete response to this treatment in the beginning. This means that the cancer can no longer be detected, which is called remission. After the disease is in remission, they are then given consolidation therapy. This includes additional cycles of ATRA and arsenic trioxide.
People with lower-risk forms of APL may be able to avoid chemotherapy altogether. Others may need chemotherapy as part of their consolidation therapy.
Some people with higher-risk disease may be given chemotherapy directly into the fluid that surrounds the spinal cord and brain. This process is called intrathecal chemotherapy.
After consolidation therapy, people with high-risk disease may stay on maintenance therapy for a few years to keep the cancer from coming back. This therapy is given intermittently and combines ATRA and low-dose chemotherapy.